Rural areas in the United States face several challenges related to telehealth adoption. According to the U.S. Department of Health and Human Services, over 14% of people under 65 in rural regions do not have health insurance, which limits their ability to use many healthcare services, including telehealth. An even bigger challenge is digital access. About 22.3% of rural residents lack internet access at home. This lack of reliable broadband causes dropped calls and poor video quality during telehealth visits, leading to distrust of remote care.
Adding to these connectivity problems is a shortage of healthcare providers. Around 65.6% of Primary Care Health Professional Shortage Areas (HPSAs) exist in rural locations. This shortage increases the importance of telehealth, which can expand patient access, reduce travel, and help with provider scarcity. However, without proper infrastructure and training, few people will use telehealth.
The necessary equipment for telehealth—such as video-enabled devices, telemedicine software, and secure networks—is another barrier for many rural clinics and patients. Those without the right devices or digital skills may find it hard to fully participate in telehealth.
Finally, low health literacy and limited digital knowledge among rural residents reduce telehealth use. Many, especially older adults or those with cognitive challenges, are not comfortable with digital technology. Targeted digital literacy training is needed to help both patients and providers overcome these obstacles.
Digital literacy means having the skills to use digital technologies confidently and effectively. This includes using electronic devices, browsing the internet, identifying trustworthy information, communicating through digital platforms, and using tools like health monitoring apps. Recent research highlights digital competence as a major factor in telehealth use.
Telehealth use in the U.S. rose sharply during the COVID-19 pandemic. A report from the Office of Health Policy showed Medicare telehealth visits increased from 840,000 in 2019 to 52.7 million in 2020—a 63-fold rise. Studies show that higher digital skills strongly predict telehealth adoption. For instance, research led by Thai V. Le found that each increase in digital competence raised the chance of telehealth use during the pandemic by 72.8% and continued use afterward by 71.6%.
These numbers show that just providing telehealth technology is not enough. Training programs that teach device operation, platform navigation, and basic health information encourage ongoing use and better patient results in rural areas.
Regions with lower broadband use also saw higher COVID-19 death rates. Research by Lin and colleagues found that a 1% increase in residents without internet access corresponded to 2.4 to 6 additional COVID-19 deaths per 100,000 people. This highlights the need for initiatives addressing both digital access and skills.
Rural healthcare practices should provide digital literacy training for both patients and providers to increase telehealth use.
Artificial intelligence (AI) and workflow automation are playing a larger role in improving telehealth, especially where resources are limited.
AI can help rural healthcare providers by:
With limited staff and high patient loads, these AI tools allow rural providers to focus more on direct patient care.
For example, Simbo AI offers front-office phone automation and AI answering services. By handling routine inquiries and routing patient needs, it helps reduce staff workload and improve patient communication.
Improving digital literacy goes beyond increasing telehealth use; it also benefits rural healthcare in several ways:
Several state governments have invested in broadband expansion and digital literacy linked to telehealth. Missouri dedicated $5.25 million to install over 12,500 internet hotspots, increasing public internet access for telehealth. Iowa has upgraded broadband across surgery centers and hospitals to boost virtual care.
Healthcare leaders working in rural settings should consider these steps to support digital literacy and telehealth use:
In summary, a successful telehealth program in rural healthcare depends greatly on the digital skills of patients and providers. Addressing digital gaps through training and combining this with AI-driven workflow solutions offers a path to increasing telehealth use and improving healthcare delivery in rural communities across the United States.
The primary challenges include limited internet access, inadequate technology infrastructure, lack of healthcare providers, and low health literacy among rural residents.
Reliable broadband internet is crucial for telehealth; poor connectivity can lead to dropped calls and distrust among patients, hindering their willingness to use telehealth services.
Essential equipment includes computers for EHR, video-capable devices, landline phones, and software for remote monitoring to ensure effective telehealth delivery.
Alternative modalities include audio-only appointments, secure messaging, and asynchronous communication, particularly useful when video consultations are not feasible.
Healthcare providers can collaborate with local organizations and telecommunication companies to address broadband access issues, advocating for expansion in underserved regions.
Mobile hotspots can provide reliable internet access in areas lacking broadband, enabling patients to engage in telehealth sessions when cellular signals are strong.
Improving health literacy involves educational programs that explain telehealth’s benefits, with materials tailored for the target audience to ensure comprehension.
Training should focus on helping both healthcare providers and patients navigate telehealth platforms effectively, ensuring confidence in virtual health sessions.
Language services, including document translation and interpretation, are crucial for engaging patients with limited English proficiency, enhancing their access to telehealth.
AI can streamline appointment scheduling, automate patient reminders, improve communication, manage patient data, and assist in patient outreach, enhancing overall service efficiency.
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